Our STTR Phase II proposal is designed to develop and test Cielo New Vision, the scalable, commercial health information system envisioned as a result of our Phase I work. Health Information Technology (HIT) has been at the forefront of the nation's policy considerations as we have been completing our Phase I work and this proposal for a Phase II STTR is influenced by both our Phase I findings and the current health policy context. We firmly believe there could be no better time to be launching our Phase II. The American Recovery and Reinvestment Act (ARRA) contains provisions for incentives to medical care providers to foster HIT adoption. A system that responds to our Phase I findings and allows providers to qualify for ARRA incentives, will bring a product to market that will meet the needs of many primary care providers. Our Phase I work firmly establishes that while Cielo Clinic has significant deficiencies limiting its broad use, its data principles which permit recording and tracking of care elements from earliest expression of symptoms through diagnosis and longitudinal treatment are admirably suited to building a first rate, primary care targeted, health information solution. An EHR-M or clinical groupware solution built on such a data model permits data tracking and display within patients over time and across patients by problem or diagnosis. Cielo New Vision will deliver at its core an episode of care based data structure with components that plug in to deliver specific functions. Practices may utilize the core database with any or all of the plug-ins and connect to their existing systems. In this Phase II proposal we will develop and test Cielo New Vision according to the following aims: 1. Elicit feedback from clinicians, office staff and patients on the paper prototype, both from current and prospective users. 2. Develop a working prototype of the proposed system. 3. Usability test and refine the working prototype with selected clinicians and staff from current and prospective practices and patients 4. Conduct a prospective trial comparing Cielo New Vision and EHR practices on key outcomes: delivery of evidence-based services, satisfaction of ARRA meaningful use standards and satisfaction of PCMH standards. At the completion of Phase II we will deliver a primary care targeted suite designed to capture and report comprehensive care and patient needs over time. This suite while addressing known and anticipated standards, will also permit practices with existing systems to plug in their existing technologies, leveraging their investments using our innovative data model. Patients in practices using our system will be able to track their care and needs from the early expression of symptoms through diagnosis and treatment over time. PUBLIC HEALTH RELEVANCE: At the completion of Phase II we will deliver a primary care targeted suite designed to capture and report comprehensive care and patient needs over time. This suite while addressing known and anticipated standards, will also permit practices with existing systems to plug in their existing technologies, leveraging their investments using our innovative data model. Patients in practices using our system will be able to track their care and needs from the early expression of symptoms through diagnosis and treatment over time.